Provider Demographics
NPI:1336646561
Name:DABBS, JOSEPH WAYLON (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WAYLON
Last Name:DABBS
Suffix:
Gender:M
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-9123
Mailing Address - Country:US
Mailing Address - Phone:615-336-0097
Mailing Address - Fax:
Practice Address - Street 1:2349 RUSSELLVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-3986
Practice Address - Country:US
Practice Address - Phone:270-282-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173732101YA0400X
MA21240101YA0400X
MA1244241041C0700X
TN75551041C0700X
KY2555851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)